Table 6.
Perinatal mental health outcomes during COVID-19 as a function of cultural or geographic factors.
| Study | Study Design | Country | Study Period | Recruitment Sites/Methods | Participant Characteristics | Main Findings | Risk of Biasa | ||
|---|---|---|---|---|---|---|---|---|---|
| Pregnancy/ Postpartum Status |
Subgroups | Maternal Age | |||||||
| Bo et al. (103) | Cross-sectional | China | February 22–March 10, 2020 (during the pandemic) | Social media | Pregnant and postpartum women (N = 1,309) • 1st & 2nd trimester: n = 373 • 3rd trimester: n = 545 • Postpartum: n = 391 |
High-risk area residents (Central/Western China; n = 418) vs. Low-risk area residents (Northern/Southern China; n = 891) | 29.99 (M) ± 4.53 (SD) years | 27.43% of participating women reported depression. Women living in high-risk area (central/western China), compared to women living in low-risk area (northern/southern China), were more likely to report depression. Risk factors: concerns about COVID-19 infection and delayed regular medical check-ups | 6 |
| Dong et al. (104) | Cross-sectional | China | February 22–27, 2020 (during the pandemic) | Social media and workplaces | Pregnant women (N = 156) • 0–12 weeks GA: n = 36 • 13–24 weeks GA: n = 46 • 25–40 weeks GA: n = 74 |
High-risk area residents (Wuhan; n = 101) vs. Low-risk area residents (other provinces in China; n = 55) | 20–25 years: n = 4 26–30 years: n = 91 31–50 years: n = 61 |
There was no difference in depressive and anxiety symptoms in women living in high-risk area (Wuhan) compared to those living in other areas. | 8 |
| Liu et al. (17) | Cross-sectional | China | February 3–9 2020 (during the pandemic) | Hospitals | Pregnant women (N = 1,947) • 1st trimester: n = 83 • 2nd trimester: n = 639 • 3rd trimester: n = 1,125 |
High-risk area residents (Wuhan; n = 932) vs. Low-risk area residents (Chongqing; n = 1,015) | <35 years: n = 1,734 ≥35 years: n = 213 |
17.2% of participating women reported anxiety. Pregnant women residing in a high-risk area (Wuhan) reported higher anxiety compared to women residing in low-risk areas. (Chongqing) | 9 |
| Spinola et al. (105) | Cross-sectional | Italy | May 11–June 6, 2020 (lockdown period during the pandemic) | Social media | Postpartum women (<1 year; N = 243) |
High-risk area residents (Northern Italy; n = 131) vs. Low-risk area (Central or Southern Italy; n = 109) | 34.01 (M) ± 4.27 (SD) years | 44% of participating women reported postpartum depression. Women who spent isolation in high-risk areas (northern Italy) reported greater postpartum depression and adopted more maladaptive coping strategies than women living in lower risk areas. Risk factors: prior abortion, previous psychiatric history, COVID-19 infection. | 6 |
| Taubman–Ben-Ari et al. (106) | Cross-sectional | Israel | March 18–28, 2020 (during the pandemic) | Social media | Pregnant women (N = 336) • GA: 25.42 (M) ± 9.57 (SD) weeks |
Ethnic minority (Arab; n = 111) vs. Ethnic majority (Jewish; n = 225) | 30.31 (M) ± 4.97 (SD) years | Women of ethnic minority (Arab) reported more anxiety symptoms than women of a majority ethnicity (Jewish) | 7 |
| Zhang et al. (107) | Cross-sectional | China | February 13–16, 2020 (during the pandemic) | Hospitals | Pregnant women (N = 1,901) |
High risk area (Central China; n = 406) vs. Low risk area (Other provinces in China; n = 1,495) | 28.9 (M) ± 4.7 (SD) years | Women living in the epicenter (Hubei) reported higher psychological symptoms, such as PTSD, during the pandemic than women in other provinces and in pre-pandemic samples. | 6 |
GA, gestational age; M, mean; SD, standard deviation; Med, median; R, range; PTSD, post-traumatic stress disorder.
a
Assessed using a modified version of the Newcastle-Ottawa Scale (54). See section Assessment of Risk of Bias for details. Scores range from 0 (highest bias) to 10 points (lowest bias).